The Final Diagnosis (27 page)

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Authors: Arthur Hailey

Tags: #Fiction, #Medical, #Thrillers, #Suspense

BOOK: The Final Diagnosis
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For an instant he feared he had been unwise. He thought he detected a sudden coolness, a hint of pained surprise. Then it was gone. She said simply, “Why don’t we do that?”

Outside the Buick was waiting, the doors held open, the motor running. Going across town, he drove carefully, more slowly then usual, aware he had had a good deal to drink. It was a warm night and the car windows were down. From the other side of the front seat he caught a subtle breath of perfume once again. At his apartment he parked the car on the street and they went up in the elevator.

When he had mixed drinks he took them across and gave the old-fashioned to Denise. She was standing by an open window in the living room, looking out at the lights of Burlington below. The river which ran through the city cut a deep swath of darkness between both its banks.

Standing beside her, he said quietly, “It’s been a while since I mixed an old-fashioned. I hope it isn’t too sweet.”

She sipped from the glass. Then softly, huskily, “Like so much else about you, Kent, it’s absolutely right.”

Their eyes met and he reached out for her glass. When he had put it down she came gently, effortlessly, to him. As they kissed his arms tightened around her.

Then stridently, imperiously, in the room behind them a phone bell clamored out. There was no ignoring it.

Gently Denise disengaged herself. “Darling, I think you’d better answer it.” She touched his forehead gently with her lips.

As he crossed the room he saw her gather up her purse, stole, and gloves. It was obvious the evening was over. Almost angrily he picked up the phone, answered curtly, and listened. Then the anger dissolved. It was the hospital—the night-duty intern. One of O’Donnell’s own patients had developed symptoms which appeared to be serious. He asked two swift questions, then, “Very well, I’ll come at once. Meanwhile, alert the blood bank and prepare for a transfusion.” He broke the connection, then called the night porter to get a taxi for Denise.

 

Fourteen

 

Most nights of the week Dr. Joseph Pearson made a practice of going to bed early. Necessarily, though, on the evenings he played chess with Eustace Swayne he was much later—an occurrence which left him tired and more irritable than usual next morning. This effect, from last night’s session, was with him now.

Working his way through purchase requisitions for lab supplies—a task he detested ordinarily and more than ever at this moment—he snorted and put one of the vouchers aside. He scribbled a few more signatures, then paused again and snatched a second voucher from the pile. This time there was a scowl as well as the snort. An ultimate would have known the danger signs—Dr. Pearson was ready to blow his top.

The moment came when he hesitated over a third voucher. Then, explosively, he threw his pencil down, grabbed up all the papers in an untidy heap, and made for the door. Storming into the serology lab, he looked around for Bannister. He found the senior technician in a corner preparing a stool culture.

“Drop whatever you’re doing and come over here!” Pearson dumped the pile of papers on a center table. Several fell to the floor, and John Alexander bent down to retrieve them. He felt an instinctive relief that Bannister, and not himself, was the object of Dr. Pearson’s anger.

“What’s the trouble?” Bannister strolled across. He was so used to these outbursts that sometimes they had the effect of making him calmer.

“I’ll tell you what’s the trouble—it’s all these purchase orders.” Pearson himself was more subdued now, as if his ill temper was simmering instead of being on the boil. “Sometimes you seem to think we’re running the Mayo Clinic.”

“We gotta have lab supplies, haven’t we?”

Ignoring the question, “There are times I wonder if you eat the stuff. And besides, didn’t I tell you to put a note on anything out of the ordinary, explaining what it was for?”

“I guess I forgot.” Bannister’s tone was resigned.

“All right, you can start remembering.” Pearson picked a form from the top of the pile. “What’s the calcium oxide for? We never use that here.”

Bannister’s face creased in a malicious grin. “
You
asked me to get that. Isn’t it for your garden?” The senior technician was referring to a fact which both of them knew but seldom spoke of. As one of the county horticultural society’s leading rose growers, Joe Pearson absorbed a goodly quantity of hospital lab supplies in improving the growing power of his soil.

He had the grace to appear embarrassed. “Oh . . . yeah . . . okay, let that one go.” He put down the voucher and picked up a second. “What about this one? Why do we want Coombs serum all of a sudden? Who ordered that?”

“It was Dr. Coleman.” Bannister answered readily; this was a subject he had hoped would come up. Alongside him John Alexander had a sense of foreboding.

“When?” Pearson’s question was sharp.

“Yesterday. Dr. Coleman signed the requisition anyway.” Bannister pointed to the voucher, then added maliciously, “In the place where you usually sign.”

Pearson glanced down at the form. Until now he had not noticed there was a signature on it. He asked Bannister, “What does he want it for? Do you know?”

The senior technician relaxed. He had set the wheels of retribution in motion and now he could enjoy this scene as a spectator. He told John Alexander, “Go ahead. Tell him.”

A shade uneasily John Alexander said, “It’s for a blood-sensitization test, Dr. Pearson. For my wife. Dr. Dornberger ordered it.”

“Why Coombs serum?”

“It’s for an indirect Coombs test, Doctor.”

“Tell me—is there something special about your wife?” Pearson’s voice had an edge of sarcasm. “What’s wrong with the saline and high-protein tests? The same as we use for everybody else?”

Alexander swallowed nervously. There was a silence. Pearson said, “I’m waiting for an answer.”

“Well, sir.” Alexander hesitated, then blurted out, “I suggested to Dr. Coleman—and he agreed—it would be more reliable if, after the other tests, we did a——”


You
suggested to Dr. Coleman, eh?” The tone of the question left no doubt of what was about to happen. Sensing it, Alexander blundered on.

“Yes, sir. We felt that since some antibodies can’t be detected in saline and high protein, running the extra test——”

“Cut it out!” The words were loud, harsh, brutal. As he said them Pearson slammed his hand hard down on the pile of forms and the table beneath. There was silence in the laboratory.

Breathing hard, the old man waited, eying Alexander. When he was ready he said grimly, “There’s one big trouble with you—you’re just a bit too free with some of that stuff you picked up in technician’s school.”

As Pearson spoke his bitterness came through—the bitterness against all who were younger, who were interfering, trying to deprive him of authority—absolute and unquestioned—which until now had been his. In a different mood, and at another time, he might have handled this more tolerantly. Now, coming as it did, he had plainly decided, once and for all, to put this upstart lab assistant in his place.

“Listen to me and get this straight! I told you this once before and I don’t aim to do it again.” This was Authority speaking, the head of a department, heavy-handed, making it clear to a minor employee that there would be no more warnings, merely action, from this point on. His face close to Alexander’s, Pearson said, “I’m the one in charge of this department, and if you or anybody else have any queries, they come to me. Do you understand?”

“Yes, sir.” At this instant all Alexander wanted was for this to end. He already knew he had made his last suggestion. If this was what you got for thinking, from here on he would do his work and keep his thoughts to himself. Let other people do the worrying—and let them have the responsibility too.

But Pearson had not finished. “Don’t go running around behind my back,” he said, “and taking advantage of Dr. Coleman because he’s new.”

Briefly Alexander’s spirit flared. “I didn’t take advantage . . .”

“And I say you did! And I’m telling you to cut it out!” The old man shouted angrily, his face muscles working, his eyes fiery.

Alexander stood, crushed and silent.

For a moment or two Pearson surveyed the younger man grimly. Then, as if satisfied that his point was made, he went on to speak again. “Now I’ll tell you something else.” His tone this time, if not cordial, was at least less harsh. “As far as that blood test is concerned, a test in saline and high protein will give us all the information we need. And let me remind you I happen to be a pathologist and I know what I’m talking about. Have you got that?”

Dully Alexander answered, “Yes, sir.”

“All right. I’ll tell you what I’ll do.” Pearson’s voice became more moderate; it was almost as if he were offering a truce. “Since you’re so keen on this test being right, I’ll do it myself. Here and now. Where’s the blood specimen?”

“In the refrigerator,” Bannister said.

“Get it.”

Crossing the lab, Bannister decided this scene had not turned out exactly the way he would have liked. It was true the Alexander kid had needed to be taken down a peg, but, all the same, the old man had laid it on the kid a bit hard. Bannister would have liked to see some of the storm move in the direction of that snide young doctor. But maybe the old man was saving that for later. He selected the blood specimen marked “Alexander, Mrs. E.” and closed the refrigerator door.

Pearson took the blood sample, which already had the clot removed. As he did, Bannister noticed the purchase order which had been the cause of the trouble; it had fallen to the floor. He bent down and picked it up.

He asked Pearson, “What shall I do with this?”

The old pathologist had taken two clean test tubes. Now he was aspirating a portion of the blood serum into each. Without looking up he said irritably, “What is it?”

“It’s the purchase requisition—for Coombs serum.”

“We won’t need it now. Tear it up.” Pearson was scrutinizing the label of a small bottle containing Rh-positive cells. Prepared by a drug house, the solution was used as a reagent in testing Rh-negative blood.

Bannister hesitated. Much as he objected to Coleman, he knew there was a question of medical protocol involved. “You ought to let Dr. Coleman know,” he said doubtfully. “Do you want me to tell him?”

Pearson was having trouble with the cork of the bottle. He said impatiently, “No, I’ll tell him myself.”

Bannister shrugged. He had pointed something out; if there were any trouble now, it would not be his responsibility. He took the purchase requisition and tore it up, allowing the pieces to flutter down into a wastebasket below.

 

Roger McNeil, the pathology resident, suspected that no matter how many years he stayed in medicine he would never become hardened to performing autopsies on children. He had just completed one, and now, in the autopsy room, the red-gaping body of the four-year-old boy lay open, pathetically, before him. The sight disturbed McNeil as much as ever. He knew, as always, there would be little sleep for him tonight. This scene would keep recurring in his mind—particularly when he remembered, as inevitably he would, how unnecessary and futile this particular death had been.

Looking up, he saw Mike Seddons watching him. The surgical resident said, “Poor little bastard.” Then, bitterly, “How stupid can people get!”

McNeil asked, “Are the police still waiting?”

Seddons nodded. “Yes—and the others.”

“You’d better call Pearson.”

“All right.” There was a telephone in the autopsy-room annex, and Seddons went to it.

McNeil wondered if he were being cowardly in avoiding this responsibility. But this was a case the old man should be told of anyway. Then he could make the decision on who would break the news outside this room.

Seddons had returned from the phone. “Pearson was in Serology,” he said. “He’s coming across now.”

The two men waited silently. Then they heard Pearson’s shuffling footsteps, and the old man came in. He glanced at the body as McNeil recited the details of the case. An hour or two earlier the child had been struck by an automobile outside his own home. He had been brought to the hospital by ambulance but was dead on arrival. Notified, the coroner had ordered an autopsy. McNeil told Pearson what they had discovered.

The old man said, “You mean that’s all?” He seemed incredulous.

McNeil answered, “That’s all that killed him. Nothing else.”

Pearson moved toward the body, then stopped. He knew McNeil well enough to be aware that the resident would have made no mistake. He said, “Then they must have just stood there . . . and watched.”

Seddons put in, “Most likely nobody knew what was happening.”

Pearson nodded slowly. Seddons wondered what the old man was thinking. Then Pearson asked, “How old was the child?”

“Four,” McNeil answered. “Nice-looking kid too.”

All of them glanced at the autopsy table and the still, small figure. The eyes were closed, the fair, tousled hair pulled back in place now that the brain had been removed. Pearson shook his head, then turned toward the door. Over his shoulder he said, “All right; I’ll go up and tell them.”

The three occupants of the hospital anteroom looked up as Pearson entered. One was a uniformed patrolman of the city police, and near him was a tall man whose eyes were red-rimmed. The third occupant—dejected and sitting alone in the far corner—was a mousy little man with a straggling mustache.

Pearson introduced himself. The patrolman said, “I’m Stevens, sir. Fifth Precinct.” He produced a notebook and pencil.

Pearson asked him, “Were you at the scene of the accident?”

“I arrived just after it happened.” He indicated the tall man. “This is the father of the boy. The other gentleman was the driver of the car.”

The mousy man looked up. Appealing to Pearson, he said, “He ran straight out—straight out from the side of the house. I’m not a careless driver. I’ve got kids of my own. I wasn’t going fast. I was almost stopped when it happened.”

“And I say you’re a lousy liar.” It was the father, his voice choked with emotion and bitterness. “You killed him, and I hope you go to jail for it.”

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